Skip to main content

Prostate specific antigen test uptake: a cross sectional study on elderly men in Western Iran

Abstract

Background

Prostate cancer (PCa) is the second most common malignancy in men worldwide and the incidence rate of PCa has been increasing in recent years. The aim of the current study was to determine beliefs elderly men towards prostate-specific antigen (PSA) test uptake.

Methods

This cross-sectional study conducted among 352 elderly men (60–74 years old age) in the west of Iran. The Health Belief Model (HBM) was applied as a study framework to evaluation of beliefs towards PSA test uptake. Data were analyzed by SPSS version 16 using appropriate statistical tests including t-test, chi-square, bivariate correlations, and logistic regression at 95% significant level.

Result

The mean age of participants was 65.55 years [SD: 3.90]. Almost 16.9% of the elderly men had uptake PSA during last year. There was significant association between PSA test uptake with older age (P = 0.013), better economic status (P = 0.023), higher education level (P = 0.004), positive family history of prostate cancer (P = 0.018), and number of family members more than four (P = 0.032). The best determinants predictors for PSA test uptake were cues to action [OR: 1.967 and 95% CI: 1.546, 2.504], perceived severity [OR: 1.140 and 95% CI: 1.008, 1.290], and perceived benefits towards PSA test uptake [OR: 1.133 and 95% CI: 1.024, 1.253].

Conclusions

It seems that development of health promotion programs to increase cues to action and positive beliefs toward PSA test uptake and also perceived treat about side effect of PCa could be beneficial to increase PSA test uptake.

Peer Review reports

Background

Prostate cancer (PCa) is the second most common malignancy in men worldwide, counting 1,276,106 new cases and causing 358,989 deaths (3.8% of all deaths caused by cancer in men) in 2018 [1]. The incidence rate of this cancer has been increasing in recent years [2]. The growing rate of PCa cases has also been evident in Iran for the last 10 years [3]. Despite major differences in the incidence rate of this malady, PCa could mainly be considered as an illness related to men who are older than 65 years since more than 75% of its new cases are diagnosed in men older than 65 years [4]. However, other causes include racial differences, genetic and environmental factors, family history, hormonal changes related to aging, poor nutrition (especially consuming monounsaturated fats), smoking or alcohol consumption [5]. Availability and access to diagnostic and health-care services as well as recommendations regarding PCa testing may be usefulness of the results in order to reduce incidence and mortality rates [2]. American cancer society recommended that men over 50 years of age should receive a PCa screening test; serologic test for assessing prostate-specific antigen (PSA) level is the most important method, which is also the most practical one, easiest and most sensitive detection test (97% specificity and 67% sensitivity) [6]. Iran, the private and public sectors both provide health care and treatment services; however, public sector and specially the ministry of health play a more significant role in this regard [7]. About 90% of Iranians covered by some form of health insurance [8], for example, many cancer screening tests at public health centers in Iran are performed for free or are covered by health insurance in the target group population [9]. However, the rate of cancer screening tests in Iranians is low [3, 9]. For encouraging population to uptake screening tests, some studies have emphasized the utilization of fear appeal strategies and interventions which are based on increased knowledge in the framework of prostate cancer prevention programs for health educators [10]. This issue indicates the importance of considering the psychological aspects of participation in cancer screening programs, and, theoretical knowledge of health education experts and utilization of theory-based approaches regarding why people perform or not perform a behavior could guide the experts for designing an effective and efficient educational program [11]. It seems that using cognitive determinants like health belief model (HBM) constructs for develop educational programs can enhance men’s knowledge of PCa, change their health beliefs and improve their behaviors regarding screening programs like PSA. For example, Bilgili et al. [12] conducted a study on 650 Turkish men aged 40 years old and older and showed that strong positive correlation between knowledge and seriousness perception of PCa. Moreover, several studies have been carried out to assess the HBM determinants predict the PCa screening behaviors and indicated that the when men perceive the benefits of screening behavior, they can defeat the barriers and costs of the behavior through believing in their ability to perform these behaviors (perceived self-efficacy) and uptake test [13, 14]. Furthermore, perceived susceptibility and perceived severity of people refers to their belief based on their vulnerability to PCa [15, 16]. The HBM is one of the most commonly used models in the field of PCa screening behaviors [12,13,14,15,16,17]. The objective of current study was to determine prevalence and determinates related to uptake PSA test among sample of Iranian elderly men based on the HBM.

Methods

Study design and study population

This cross-sectional study was conducted on 352 elderly men (60–74 years old age) in the Kermanshah Province in the western part of Iran. Kermanshah is the capital of Kermanshah Province, is located in western Iran and close to Iraq; according to the last census, its population is 946,681 (2019 estimate 1,046,000); a majority of the population language is Kurdish. Kermanshah has a moderate and mountainous climate [18]. To register the participants and collect the data, the following steps were done. At first, different parts of the city were divided into eight regions based on the municipalities and one health center was selected from each region. Subsequently, elderly men referred to the health centers for taking health care, were randomly selected into the current study voluntarily. Men aged 60 to 74 years, and speak Kurdish fluently were eligible to participate in this study. The sample size was calculated at 95% significant level according to the results of a pilot study. According to the PSA test uptake rate among elderly men in the pilot study (which is 26% and taking into account the 5% error), the required sample size was estimated at 352 people. Among 352 elderly men invited to participate in our study, 320 elderly men signed the consent form and voluntarily agreed to participate in the study, which has been approved by the research ethics committee at the Kermanshah University of Medical Sciences, Kermanshah, Iran (IR.KUMS.REC.1398.431). The response rate was 90.9%.

The study tool

The questionnaire consists of three parts: 7 questions for demographic factors, 1 item about PSA test uptake and 23 items for HBM determinants. The designed questionnaire has been uploaded as a supplementary file.

Demographics

The demographics variables assessed in current study included: age (year), marital status (married, single), economic status (weak, middle, good), education (primary school, secondary school, high school, and academic), family member size (1–4 number, More than 4 number), health insurance (yes, no), and history of a family person who has had PCa (yes, no).

HBM theoretical determinants

The items which assessed determinants of the HBM were derived from the questionnaires of beliefs towards PCa screening behaviors [12,13,14,15,16,17] and in accordance with expert panel comments. The expert panel included five health educators, two health policymakers, two health services manager, one public health expert, and two urologists. There were 23 items which measured the six determinants of 1) perceived benefits, 2) perceived barriers, 3) perceived susceptibility, 4) perceived severity, 5) perceived self-efficacy, and, 6) cues to action. In order to facilitate participants’ responses to the items, all items were standardized to a five-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree) was used to measure the perceived benefits, perceived barriers, perceived susceptibility, perceived severity, and perceived self-efficacy. Furthermore, for measured the cues to action was used yes or no. The face validity of the questionnaire was evaluated qualitatively. Thus, face-to-face individual interviews were held up with 12 experts, their comments analyzed and the necessary modification performed. In addition, prior to conducting the main project, a pilot study was conducted to assess the internal consistency of the questionnaire and estimating the sample size. The pilot study subjects were 30 elderly men, similar to those who participated in the main study. Cronbach’s Coefficient Alpha was used to estimate the internal consistency of the various measures. Table 1 shows the HBM scale items.

Table 1 The HBM questionnaire items

PSA test uptake questionnaire

To assess whether or not the subjects had experimented with PSA test uptake, we used one items “Have you PSA test uptake at during last year” which the response category was yes or no.

Statistical methods

Quantitative variables were expressed as means with SDs, and qualitative/categorical ones as frequencies and percentages. Multivariable logistic regression models were performed to predict study outcomes of PSA. A stepwise backward approach was used to select the independent variables for the final models. Results of logistic models were expressed as ORs with 95% CIs. Bivariate correlations were computed to ascertain the magnitude and direction of the associations between the HBM determinants scores. Independent sample t-test and chi-square were used to assess the relationship between demographics variables and PSA test uptake. The level of significance was (P <  0.05). Data were analyzed by the SPSS software for Windows (ver. 16).

Results

The mean age of respondents was 65.55 ± 3.90 years [95% CI: 65.13, 65.98], ranged from 60 to 74 years. Almost 16.9% of the elderly men had PSA test uptake during last year. There was significant association between PSA test uptake with older age (P = 0.013), better economic status (P = 0.023), higher education level (P = 0.004), positive family history of PCa (P = 0.018), and number of family members more than four (P = 0.032). More details regarding demographic characteristics of the participants are shown in Table 2.

Table 2 Demographic variable and PSA test uptake

Logistic regression (backward stepwise method) was performed to explain the demographic variable related to PSA test uptake (yes, no), and the best model was selected in the 2th step. Among the demographic variable, age, education level, economic status, family member size, health insurance and positive history of PCa were the most influential predictive factors related to PSA test uptake (Table 3).

Table 3 Multiple logistic regression results for demographic variable related to PSA test uptake

Table 4 shows the Zero-order correlations. Significance levels at the 0.01 and 0.05 were the criteria for the analysis. The bivariate assessment of variables revealed that there were signs of multicollinearity among HBM variables.

Table 4 Bivariate correlation between predictor determinants of HBM

Logistic regression analysis and backward stepwise method was used for calculating the predictability of HBM determinants on PSA test uptake (Table 5). As mentioned in statistical analyses, a step-wise model building procedure was conducted and finally on step 4 the procedure stopped and the best model was selected. The best determinants predictors for PSA test uptake were cues to action [OR: 1.967 and 95% CI: 1.546, 2.504], perceived severity [OR: 1.140 and 95% CI: 1.008, 1.290], and perceived benefits towards PSA test uptake [OR: 1.133 and 95% CI: 1.024, 1.253].

Table 5 Multiple logistic regression analysis for determinants of HBM related to PSA test uptake

Discussion

The aim of this study was to determine prevalence and determinants related to uptake PSA test among sample of Iranian elderly men based on the HBM. According to the result 16.9% of the participants had PSA test uptake at least once. Bello et al. in their study among urban community in North-Central Nigeria reported that only 7.1% of Nigerian men had taken the PSA screening test at least once [19]. So et al. [20] stated that 10% of Chinese men aged 50 or more had taken PSA test. Burns et al. [21] carried out a research on men aged 40 years and over old in Republic of Ireland and reported that 24% of the participants had uptake of PCa screening. Furthermore, Ojewola et al. [22] in their study among 305 community-dwelling men older than 40 years in Southwest Nigeria indicated only 10.2% of them had taken the PSA screening test at least once. Furthermore, Carrasco-Garrido et al. carried out a research in Spain people and reported that the uptake PSA was 35.19% [23]. A review of these studies indicated that PSA test uptake is lower among Asian men compared to European men. In this regards, Consedine et al. stated that the likely variations in screening behavior among ethnic populations [24]. These findings can be warning to health policy makers in Asian country; and should be the focus of special attention.

The results of our study suggest that the following five demographic factors were related to the PSA test uptake among the Iranian elderly men: 1) increase age, 2) better economic status, 3) higher education level, 4) positive family history of prostate cancer, and 5) increase family member size. These results are generally consistent with the findings reported by other studies. For example, Merrill [25] in their study on 1293 men age 40 years or older in Utah reported that PSA screening significantly increased with age: 23.9% for ages 40–49, 51.4% for ages 50–59, 67.4% for ages 60–69, and 67.0% for ages 70+. Mirzaei-Alavijeh et al. [3] also conducted a study among men in western Iran and reported similar findings towards positive correlation between increased age and PCa screening tests. It seems that younger people perform less screening behaviors as they less often see themselves at risk.

In line with our finding the impact of the economic status on cancer screening behaviors has been shown in numerous studies [26,27,28,29]. In this regards, Guessous et al. [26] carried out research on 12,034 Swedish men aged ≥50 years (mean age: 63.9) and indicated men belonging to high socioeconomic status are significantly more frequently PCa screened than those less favored. Thus, higher economic level could lead to higher medical care such as screening test uptake. A national health insurance scheme may be necessary to increase PCa screening test uptake among Iranian men.

Our findings also indicated that the PSA test uptake is combined with the higher education level, which is in line with the findings of earlier studies towards investigating the factors related with cancer screening test [26, 30]. Kangmennaang et al. [30] in their study on 1244 men aged 40 and above in Namibia showed that higher education level (OR = 2.02) were more likely to screening for PCa.

Another finding of the current study was more PSA test uptake among men with a family history of PCa compared to men without a family history of PCa. This high level of PSA test uptake among men with a family history of PCa compared to men without a family history of PCa is consistent with observations from other studies. For example, Shah et al. [31] in National Health Interview Survey among male in United States reported that compared to men without a family history of PCa, men with a family history were more likely to uptake PSA. As well as, national guidelines for cancer screening emphasize screening tests for people with a family history of cancer [32]. Furthermore, having a family history of cancer may increase one understands of cancer and susceptibility of getting cancer motivate one to participate in screening [33]. The impact of family history on cancer screening tests may be attributed to health care providers’ recommendations for screening tests, increased knowledge of participants due to family history of cancer, or perhaps both.

The men who had family member size more than four had PSA test uptake more than other men. This result is similar to the results reported by other studies [3, 34]. Social support for receiving PCa screening test is often provided by one’s social network of family and friends [34]. It seems that involving families in health programs could have beneficial results for improving the society health status.

The results of the our study indicate that the perceived benefits towards the PSA test uptake, the perceived severity of PCa, and the cues to action towards the PSA test uptake, as the three main determinants of HBM, were associated with the Iranian elderly men to PSA test uptake. In the field of cancer screening test uptake, many studies have underlined the predictive potential of benefits, severity, and cues to action for uptake screening test by men ([20, 35, 36], and). Consequently, the results confirm suggestions that the HBM is a suitable theoretical basis for develop of the cancer screening promotion programs [12,13,14,15,16,17].

The perceived severity is a main fear arousal factor in explaining the behavior while people believe that they are vulnerable to get a disease [37]. Our results indicated that perceived severity of was important factor that mediate behavior to uptake PSA. Bloom et al. [35] carried out a research on 208 African American men, aged 40 to 74 years in California and indicated the positive significant associated with perceived risk and uptake PSA. Rundle et al. reported that changes in perceived PCa risk was mediator for promoting effectiveness of the PCa screening test promotion programs [28]. It seems that development of educational programs to increase seriousness about side effect of PCa could be beneficial of the results in order to PCa screening test promotion programs.

Perceived benefit refers to an individual’s assessment of the positive outcomes that are caused by a specific action [38]. Our findings showed that men who had higher perceived benefits towards PSA test uptake (OR = 1.13) was more likely to PSA test uptake. In line with our study, Avery et al. [36] in their study indicated perceived beliefs towards benefits of cancer screening can predict PSA test uptake.

According to our results, cues to action was strongest determinant was predictor PSA test uptake among the Iranian elderly men. The results of similar to studies confirm these finding [20, 39] and highlight the effectiveness of the health care workers in persuasion the men to uptake PCa screening program. For example, So et al. [20] carried out a study on 1002 men over than 50 years old in Hong Kong and reported health professionals recommendations was the strongest relationship with the PSA test uptake. Thus, health care workers can important role in the increase of cancer screening behaviors in Iranian elderly men. It seems that health care workers explaining the potential benefits of PSA testing can play an important role in promoting this test among Iranian men.

The findings reported in this study have certain limitations. First, data collection based on self-reporting, which always faces the risk of recall bias and we do not know how it could have affected the results. Second, high rejection rate is another limitation of our study. Finally, data collection only among sample of Iranian elderly men in the west of Iran and results cannot be generalized to other population of elderly men.

Conclusion

There are multiple determinates to explain the cancer screening test uptake among elderly people. The current study confirmed the applicability of the HBM to explain PSA test uptake among elderly men in Iran. We conclude that we found there is some support to use the HBM to develop health promotion programs to improve PSA screening test uptake. In the other words, our result could be beneficial for guiding practitioners and health educators to develop evidence based promotion programs to increase PSA test uptake. Thus, HBM-based assessments of behavior may provide insights for intervention to modify and improve individuals’ beliefs towards benefits of PSA test uptake. Moreover, it seems that development of health promotion programs to increase cues to action and positive beliefs toward PSA test uptake and also perceived treat about side effect of PCa could be beneficial to increase PSA test uptake. Also, health care workers advice had an important role in persuading to PSA test uptake.

Availability of data and materials

Please contact the corresponding author for data requests.

Abbreviations

HBM:

Health Belief Model

PCa:

Prostate cancer

PSA:

Prostate Specific Antigen

OR:

Odds Ratio

SD:

Standard Deviation

SPSS:

Statistical Package for Social Sciences

References

  1. 1.

    Rawla P. Epidemiology of prostate Cancer. World J Oncol. 2019;10(2):63.

    CAS  PubMed  PubMed Central  Google Scholar 

  2. 2.

    Taitt HE. Global trends and prostate cancer: a review of incidence, detection, and mortality as influenced by race, ethnicity, and geographic location. Am J Mens Health. 2018;12(6):1807–23.

    PubMed  PubMed Central  Google Scholar 

  3. 3.

    Mirzaei-Alavijeh M, Ahmadi-Jouybari T, Vaezi M, Jalilian F. Prevalence, cognitive and socio-demographic determinants of prostate cancer screening. Asian Pac J Cancer Prev. 2018;19(4):1041.

    PubMed  PubMed Central  Google Scholar 

  4. 4.

    Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin. 2016;66(1):7–30.

    Google Scholar 

  5. 5.

    Mottet N, Bellmunt J, Bolla M, Briers E, Cumberbatch MG, De Santis M, Fossati N, Gross T, Henry AM, Joniau S, Lam TB. EAU-ESTRO-SIOG guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol. 2017;71(4):618–29.

    PubMed  Google Scholar 

  6. 6.

    Smith RA, Manassaram-Baptiste D, Brooks D, Doroshenk M, Fedewa S, Saslow D, et al. Cancer screening in the United States, 2015: a review of current American cancer society guidelines and current issues in cancer screening. CA Cancer J Clin. 2015;65(1):30–54.

    PubMed  Google Scholar 

  7. 7.

    Khangah HA, Jannati A, Imani A, Salimlar S, Derakhshani N, Raef B. Comparing the health care system of Iran with various countries. Health Scope. 2017;6(1):e34459.

    Google Scholar 

  8. 8.

    Mehrdad R. Health system in Iran. JMAJ. 2009;52(1):69–73.

    Google Scholar 

  9. 9.

    Aminisani N, Fattahpour R, Dastgiri S, Asghari-Jafarabadi M, Allahverdipour H. Determinants of breast cancer screening uptake in Kurdish women of Iran. Health PromotPerspect. 2016;6(1):42–6.

    Google Scholar 

  10. 10.

    Lu HY, Andrews JE, Hou HY. Optimistic bias, information seeking and intention to undergo prostate cancer screening: a Taiwan study on male adults. J Mens Health. 2009;6(3):183–90.

    PubMed  PubMed Central  Google Scholar 

  11. 11.

    Kok G, Gottlieb NH, Peters GJ, Mullen PD, Parcel GS, Ruiter RA, Fernández ME, Markham C, Bartholomew LK. A taxonomy of behaviour change methods: an intervention mapping approach. Health Psychol Rev. 2016;10(3):297–312.

    PubMed  Google Scholar 

  12. 12.

    Bilgili N, Kitis Y. Prostate Cancer screening and health beliefs: a Turkish study of male adults. Erciyes Med J. 2019;41(2):164–70.

    Google Scholar 

  13. 13.

    Louis JP. Exploring constructs of the health belief model as predictors to haitian men's intention to screen for prostate cancer. Urol Nurs. 2019;39(2):72-82.

  14. 14.

    Abuadas MH, Petro-Nustas W, Albikawi ZF, Mari M. Predictors of prostate cancer screening intention among older men in Jordan. Int J Urol Nurs. 2017;11(1):31–41.

    Google Scholar 

  15. 15.

    Modeste NN, Cort M, McLean JE. The protection motivation theory and its impact on prostate cancer screening in Guyana. Int Public Health J. 2018;10(2):181.

    Google Scholar 

  16. 16.

    Tasci-Duran E, Koc S, Korkmaz M. Turkish social attitudes towards to cancer prevention: a health belief model study. Asian Pac J Cancer Prev. 2014;15(18):7935–40.

    PubMed  Google Scholar 

  17. 17.

    Çapık C, Gözüm S. Development and validation of health beliefs model scale for prostate cancer screenings (HBM-PCS): evidence from exploratory and confirmatory factor analyses. Eur J Oncol Nurs. 2011;15(5):478–85.

    PubMed  Google Scholar 

  18. 18.

    Rostami M, Jalilian A, Rezaeian S, Kamali A. Gender and spatial disparities of suicide mortality risk in Kermanshah Province, Iran: a brief report. Dr. Sulaiman Al Habib Med J. 2019;1(3,4):55–57s.

    Google Scholar 

  19. 19.

    Bello JO, Buhari T, Mohammed TO, Olanipekun HB, Egbuniwe AM, Fasiku OK, Wasiu R. Determinants of prostate specific antigen screening test uptake in an urban community in north-Central Nigeria. Afr Health Sci. 2019;19(1):1665–70.

    PubMed  PubMed Central  Google Scholar 

  20. 20.

    So WK, Choi KC, Tang WP, Lee PC, Shiu AT, Ho SS, Chan HY, Lam WW, Goggins WB, Chan CW. Uptake of prostate cancer screening and associated factors among Chinese men aged 50 or more: a population-based survey. Cancer Biol Med. 2014;11(1):56.

    PubMed  PubMed Central  Google Scholar 

  21. 21.

    Burns R, Walsh B, Sharp L, O'neill C. Prostate cancer screening practices in the Republic of Ireland: the determinants of uptake. J Health Serv Res Policy. 2012;17(4):206–11.

    PubMed  Google Scholar 

  22. 22.

    Ojewola RW, Oridota ES, Balogun OS, Ogundare EO, Alabi TO, Banjo OO, Laoye A, Adetunmbi B, Adebayo BO, Oluyombo R. Knowledge, attitudes and screening practices regarding prostatic diseases among men older than 40 years: a population-based study in Southwest Nigeria. Pan Afr Med J. 2017;27:151.

    PubMed  PubMed Central  Google Scholar 

  23. 23.

    Carrasco-Garrido P, Hernandez-Barrera V. Lopez de Andres a, Jimenez-Trujillo I, Gallardo Pino C, Jimenez-Garcıa R. awareness and uptake of colorectal, breast, cervical and prostate cancer screening tests in Spain. Eur J Public Health. 2014;24(2):264–70.

    PubMed  Google Scholar 

  24. 24.

    Consedine NS, Morgenstern AH, Kudadjie-Gyamfi E, Magai C, Neugut AI. Prostate cancer screening behavior in men from seven ethnic groups: the fear factor. Cancer Epidemiol Prev Biomark. 2006;15(2):228–37.

    Google Scholar 

  25. 25.

    Merrill RM. Demographics and health-related factors of men receiving prostate-specific antigen screening in Utah. Prev Med. 2001;33(6):646–52.

    CAS  PubMed  Google Scholar 

  26. 26.

    Guessous I, Cullati S, Fedewa SA, Burton-Jeangros C, Courvoisier DS, Manor O, Bouchardy C. Prostate cancer screening in Switzerland: 20-year trends and socioeconomic disparities. Prev Med. 2016;82:83–91.

    PubMed  Google Scholar 

  27. 27.

    Drazer MW, Huo D, Eggener SE. National prostate cancer screening rates after the 2012 US preventive services task force recommendation discouraging prostate-specific antigen–based screening. J Clin Oncol. 2015;33(22):2416–23.

    PubMed  Google Scholar 

  28. 28.

    Rundle A, Neckerman KM, Sheehan D, Jankowski M, Kryvenko ON, Tang D, Rybicki BA. A prospective study of socioeconomic status, prostate cancer screening and incidence among men at high risk for prostate cancer. Cancer Causes Control. 2013;24(2):297–303.

    PubMed  Google Scholar 

  29. 29.

    Karlsen RV, Larsen SB, Christensen J, Brasso K, Friis S, Tjønneland A, Dalton SO. PSA testing without clinical indication for prostate cancer in relation to socio-demographic and clinical characteristics in the Danish diet, Cancer and Health Study. Acta Oncol. 2013;52(8):1609–14.

    PubMed  Google Scholar 

  30. 30.

    Kangmennaang J, Mkandawire P, Luginaah I. What prevents men aged 40–64 years from prostate cancer screening in Namibia? J Cancer Epidemiol. 2016;2016:7962502.

    PubMed  PubMed Central  Google Scholar 

  31. 31.

    Shah M, Zhu K, Palmer RC, Wu H. Family history of cancer and utilization of prostate, colorectal and skin cancer screening tests in US men. Prev Med. 2007;44(5):459–64.

    PubMed  Google Scholar 

  32. 32.

    Catalona WJ, Antenor JA, Roehl KA. Screening for prostate cancer in high risk populations. J Urol. 2002;168(5):1980–4.

    PubMed  Google Scholar 

  33. 33.

    Meiser B, Cowan R, Costello A, Giles GG, Lindeman GJ, Gaff CL. Prostate cancer screening in men with a family history of prostate cancer: the role of partners in influencing men’s screening uptake. Urology. 2007;70(4):738–42.

    PubMed  Google Scholar 

  34. 34.

    Dickey SL, Cormier EM, Whyte J IV, Graven L, Ralston PA. Demographic, social support, and community differences in predictors of African-American and white men receiving prostate Cancer screening in the United States. Public Health Nurs. 2016;33(6):483–92.

    PubMed  Google Scholar 

  35. 35.

    Bloom JR, Stewart SL, Oakley-Girvans I, Banks PJ, Chang S. Family history, perceived risk, and prostate cancer screening among African American men. Cancer Epidemiol Prev Biomark. 2006;15(11):2167–73.

    Google Scholar 

  36. 36.

    Avery KN, Metcalfe C, Vedhara K, Lane JA, Davis M, Neal DE, Hamdy FC, Donovan JL, Blazeby JM. Predictors of attendance for prostate-specific antigen screening tests and prostate biopsy. Eur Urol. 2012;62(4):649–55.

    PubMed  Google Scholar 

  37. 37.

    Ruiter RA, Kessels LT, Peters GJ, Kok G. Sixty years of fear appeal research: current state of the evidence. Int J Psychol. 2014;49(2):63–70.

    PubMed  Google Scholar 

  38. 38.

    Rosenstock IM. Historical origins of the health belief model. Health Educ Monogr. 1974;2(4):328–35.

    Google Scholar 

  39. 39.

    Odedina FT, ScrivensJr JJ, Larose-Pierre M, Emanuel F, Adams AD, Dagne GA, Pressey SA, Odedina O. Modifiable prostate cancer risk reduction and early detection behaviors in black men. Am J Health Behav. 2011;35(4):470–84.

    PubMed  Google Scholar 

Download references

Acknowledgements

This research project supported by Kermanshah University of medical sciences, Kermanshah, Iran. We would like to thank deputy of research of Kermanshah University of medical sciences for support. Also, we special thanks are given to all of the elderly men who participated in this study.

Funding

No

Author information

Affiliations

Authors

Contributions

Study concept and design, FJ and MMA; analysis and interpretation of data, FJ; drafting of the manuscript, FS, SK, RP, and LS; critical revision of the manuscript for important intellectual content, FJ, MMA, and AS; All authors provided comments and approved the final manuscript.

Authors’ information

Mehdi Mirzaei-Alavijeh; Ph.D. of health education and promotion, and MPH of health policy, Assistant professor of Kermanshah University of Medical Sciences in the west of Iran. https://www.scopus.com/authid/detail.uri?origin=AuthorProfile&authorId=57201700997&zone=

Farzad Jalilian; Ph.D. of health education and promotion, and MPH of health policy, Assistant professor of Kermanshah University of Medical Sciences in the west of Iran. https://www.scopus.com/authid/detail.uri?authorId=57204537193.

Laleh Solaimanizadeh; Ph.D. of health education and promotion, Assistant professor of Bam University of Medical Sciences, Iran. https://scholar.google.com/citations?user=VXkz1JYAAAAJ

Abdollah Saadatfar; MD, Urologist; Assistant professor of Kermanshah University of Medical Sciences in the west of Iran.

Shima Khashij; MSc; Researcher in Kermanshah University of Medical Sciences, Kermanshah, Iran.

Razieh Pirouzeh; Ph.D. student of health education and promotion.

Farzaneh Solaimanizadeh; BSc of Nursing; Iranian Ministry of Health and Medical Education.

Corresponding author

Correspondence to Farzad Jalilian.

Ethics declarations

Ethics approval and consent to participate

The research ethics committee at the deputy of research of the Kermanshah University of Medical Sciences, Kermanshah, Iran (IR.KUMS.REC.1398.431) had approved the study protocol and had monitored the research process. Furthermore, elderly men had been given adequate information about the purpose of the study. Individual personal information was kept confidentially. Subjects signed the consent form and voluntarily agreed to participate in the study.

Consent for publication

Not applicable.

Competing interests

The authors declare that there they have no conflicts of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Additional file 1:

Supplementary file 1. Questionnaire

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Mirzaei-Alavijeh, M., Jalilian, F., Solaimanizadeh, L. et al. Prostate specific antigen test uptake: a cross sectional study on elderly men in Western Iran. BMC Geriatr 20, 298 (2020). https://doi.org/10.1186/s12877-020-01710-9

Download citation

Keywords

  • Prostate specific antigen test
  • Elderly
  • Benefits
  • Cues to action
  • Iran